JPS6260543A - Suturing machinery for operation - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to medical equipment, and more particularly to a surgical suturing equipment for forming staple stitches.

The present invention is useful for forming linear staple stitches when suturing various organs, for suturing the intestines in surgical operations on newborns and infants, for performing surgery on difficult-to-access areas, for example, for performing surgery on small pelvises, etc. It can be used to suture organs located deep within the body, as well as to suture blood vessels in vascular surgery.

[Prior art]

In the prior art, surgical suturing instruments for forming straight stitches are known, also referred to as staplers. This suturing device includes a main body having a hook carrying a die with a plurality of recesses, a staple head having a staple magazine and a staple ejector, a restraint device for restraining tissue, and an actuator for the staple head and ejector. (U.S. Pat. No. 3,494,533).

In this type of suturing device, the free end of the hook holding the die is arranged in a cantilevered manner. Therefore, the structural rigidity of the suturing mechanism of this suturing device is determined in three mutually perpendicular directions (
i.e. the direction of the suture and the direction of the plane perpendicular to said direction)
It is insufficient in this respect.

The suturing mechanism of this device is subjected to extremely large loads during suturing operations, as the walls of the organ to be sutured must be compressed and a large number of staples must be simultaneously bent and deformed. High quality seams cannot be obtained unless the recesses of the magazine and the staple slots of the magazine are maintained in a stable relative relationship. In order to obtain the necessary structural rigidity to meet these critical requirements, the prior art devices require significantly increased cross-sectional dimensions of the hook components, the body frame, and other components of the suturing mechanism. ing.

This relatively large size of the suturing mechanism impairs the maneuverability of the device and makes it impossible to utilize the suturing device within narrow body cavities.

Additionally, because the width of the die and staple magazine is relatively large, more space is required to set the suturing device in the suturing position, and the tissue cut line from the staple seam (which is located at the edge of the magazine and die) The distance to (carried out along) is relatively large, which results in the formation of a rough seam. If the cross-sectional size of the other components of the hook of the suturing mechanism is reduced in order to deal with such problems, the components of the suturing mechanism will be considerably deformed during the suturing procedure, and the suture gap will become unacceptable. This may result in an increase in the size or distortion of the actual shape of the seam.

The aforementioned disadvantages are eliminated if the frame of the body of the suturing device is constructed as a closed frame.

Other conventional surgical suturing devices for forming straight stitches include a main body with a closed rectangular frame, and a die with a plurality of recesses is fixed to one side of the frame to form a staple. The head is mounted to the frame on the side opposite the die and is movably mounted relative to the frame (e.g., U.S. Pat. No. 4,378,90
1). A staple magazine is removably fixed within the staple head, and a staple ejector is attached to the staple head. The staple ejector is arranged to correspond to the staple slot of the magazine. The staple head actuator is housed within the body of the suturing device, and the staple ejector actuator is disposed within the staple head body.

The frame is formed into a closed rectangle and has a high structural rigidity, so even if the same load is applied to the suturing mechanism when forming a seam consisting of multiple staples, deformation of the device components is avoided. This can be significantly reduced, and the relative relationship between the staple slots of the magazine and the recesses of the die can be stabilized. This is what differentiates this suturing device from other similar devices. This suturing device can form higher quality seams and compress the seams better, thus improving the tightness and hemostatic properties of the seams. The high structural rigidity allows the cross-sectional dimensions of the device's suturing mechanism to be reduced, thus improving the maneuverability of the device within the surgical wound and reducing the distance between the stitch and the tissue cut line. This allows you to obtain more delicate seams.

However, the steno slot on the extreme side of the magazine and the recess on the extreme side of the die are significantly spaced from the sides of the frame. Additionally, this suturing device produces two rows of stitches, one row staggered relative to the other (so-called sewing bow with zigzag stitch).
Since the distances between the extreme stable slots and recesses of one row and the staple slots and recesses of the other row are naturally half of the pitch.

Therefore, a seam formed at a considerable distance along the side of the frame actually becomes a row of seams.

Since this suturing device has the configuration as described above, this suturing device is used to suture an organ in which half of the circumference at the suturing position is equal to the distance between the sides of the frame. In some cases, the edges of the organ will not be sutured with a stable suture, or will be sutured with a single row of stitches over some length. Therefore, after the magazine and die are separated and the suturing device is removed from the surgical wound, the airtight compression and hemostasis of the seams provided at the extreme ends of the sutured organ are insufficient.

In actual surgery, half the circumference of the compressed organ often exceeds the distance between the sides of the frame of the suturing instrument used. This is because it is difficult to visually estimate the dimensions and circumference of the hollow organ when it is compressed and to compare the dimensions with the distance between the sides of the frame. This is because it is difficult if observation of the site is obstructed. In such a situation,
The above-mentioned drawbacks become even more apparent.

This is because the tissue at the edges of the organ to be sutured is compressed along the length of the suture line and is free to expand as soon as the suturing instrument is removed from the surgical wound; The length increases further.

If the surgical area is well viewed and the stitches are easily accessible, staple stitch defects can be easily detected and the surgeon can place supplemental hand-stitched stitches in the extreme sections of the surgical wound. This ensures airtight compression and hemostasis of the seams. However, this suturing device cannot be used when performing surgery deep within a narrow surgical wound under difficult-to-access conditions. That is, in such situations, it is difficult to visually control the stitches or it is virtually impossible to form additional stitches in the extreme regions of the wound. This is because it is difficult to pass a threaded needle through and perform a hand sewing operation.

This suturing device can also be used in cases where the short stump of an organ can slip off and become obscured by surrounding tissue and organs after creating a mechanical stitch (stenol stitch), or when the suturing device is It cannot be used in cases where further hand-sewn sutures using thread and thread may cause trauma to delicate and easily damaged tissue. If the extremities of the organ to be sutured are not sutured, large amounts of bleeding may occur after the surgery, which may impede disinfection or cause fatal illness to the patient.

[Problem that the invention seeks to solve]

SUMMARY OF THE INVENTION An object of the present invention is to provide a surgical suturing device capable of suturing organs that are located deep within a narrow surgical wound and located in difficult-to-access locations.

Another object of the invention is to form a stable seam of high quality and stability.

Yet another object of the present invention is to provide a suturing device capable of reliably forming stable seams up to the edges of organs to be sutured.

Another object of the present invention is to provide a removable staple magazine for a suturing instrument reservoir of the type described above, increasing the reliability of the instrument and extending its functional capabilities.

[Means for solving problems]

The foregoing objects of the invention are achieved by the surgical suturing instrument of the invention for forming linear staple stitches. This suturing device includes a main body with a closed rectangular frame, a die fixed to one side adjacent to two sides of the closed rectangular frame and provided with a plurality of indentations, and an opposite side of the die. a staple head positioned within a frame and movably mounted with respect to the frame; a removable staple magazine having a plurality of staple slots and mounted within the head stationary with respect to the staple head; a staple ejector movably mounted within the staple head and disposed corresponding to the staple slot of the staple magazine; an actuator mounted within the main body of the device for actuating the staple head and the staple ejector;
It consists of: According to a feature of the invention, the inner surface of each side of the frame is provided with a slot in the immediate vicinity of the die, the axis of the slot being parallel to the side of the closed rectangular frame, and the die The portion of the staple magazine with the extreme recess and the portion of the staple magazine with the extreme staple slot are located inside said slot on the side of the frame when the magazine is in the stitching position.

Preferably, a portion of the removable staple magazine located inside the slot on the side of the frame has the same width as the slot.

If the staple magazine is provided with a guide protrusion for mounting the staple magazine in the staple head, the guide protrusion is determined by the distance between the protrusions on the sides of the frame when in the suturing position. It is preferable to provide it in the section.

Preferably, the width of a portion of the staple magazine corresponding to the lateral groove formed by the guide protrusion;
The width of the portion of the stable sewing machine located inside the slot on the side of the frame is the same.

In order to prefix the staple magazine to the staple head and to said slots on the sides of the frame, the staple magazine can be provided with a stop e in the form of a projection.

Each side of the frame may be provided with an opening communicating with the slot, and this opening may be provided in an area adjacent to the die.

Further, it is preferable that a protrusion be provided adjacent to the die on a part of the inner surface of the side of the frame, and that the protrusion be provided with a slot opening in a direction opposite to the die.

The foregoing objects are also achieved by a surgical suturing device according to another aspect of the invention for forming a straight staple seam, the suturing device comprising a body with a closed rectangular frame. a die having a plurality of recesses fixed to one side of the closed rectangular frame between the two sides; a staple head disposed within the frame on the opposite side of the die and movably mounted relative to the frame; and a staple head having a plurality of stable slots mounted statically within the staple head relative to the staple head. a staple magazine which is removable and which is arranged in a manner similar to the above; a staple ejector which is movably mounted within the staple head and is disposed corresponding to the stable sewing machine 7) within the magazine; and an actuator for actuating the staple ejector. According to the feature of the present invention, the extreme part of the die having the recess on the extreme side straddles each protrusion on the side of the frame, and the end face of the removable stable stitching thread is provided with the end face of the frame. Slots are provided corresponding to the protrusions on the sides, and the stable slots on the extreme side are located in the portions forming the slots and correspond to the recesses on the extreme side of the die.

[Effect]

In this way, a longitudinal slot is provided on the inner surface of the side of the frame in the immediate vicinity of the die, and the die part with the extreme recess and the magazine part with the extreme staple slot are connected to each other. The fit in the longitudinal slot makes it possible to increase the structural rigidity of the closed frame, allowing the cross-sectional dimensions of the components of the suturing mechanism to be relatively small, as well as reducing the gap between the magazine and the die. The organ to be sutured under pressure can be reliably restrained by the side edges of the frame, and stitches can be formed all the way to the edge of the organ. The organ to be sutured is placed between the two sides of the frame, even if half of the cross-sectional length of the organ in the free state far exceeds the distance between one side of the frame and the other side. The length of the organ is shorter than the length of the seam because it is compressed between the magazine and the die. Therefore, the reliability of the use of this suturing device can be greatly increased, the operability of the suturing device within the surgical wound is improved, and its functional performance is expanded.
Adhesion and hemostasis of staple seams can be ensured. These structural features allow the suturing device of the present invention to be used in surgeries in difficult-to-access, restricted locations, and with delicate, thin-walled tissues, such as in infant surgeries. It can be used to suture closed organs or for vascular surgery where high quality stitches are required.

Each side of the frame is provided with an opening that passes through the side in the area adjacent to the die, ensuring reliability in the extreme areas of the stitches even when the suturing device is used for long periods of time during surgery. And can form deep seams of stability. This is because the aperture greatly reduces the possibility of contamination of the extreme side recesses of the die as well as the longitudinal slots on the sides of the frame adjacent to the die, and also provides visual control. This is due to the improved performance and the ability to easily clean blood from the part of the suturing device after surgery.

This feature is extremely important. This is because, especially when the size of the staple is relatively small, for example when the diameter of the staple is smaller than 0.2 m+, as in the case of fitting small organs in infant surgery, the extremes of the die This is because if the portions of the side recesses and longitudinal slots adjacent to the die become contaminated, a seam of the required quality and stability cannot be formed.

The structural characteristics of this suturing device thus extend its functional capabilities and improve the quality, stability and reliability of stapled stitches over a longer period of use. In short, this reduces the possibility of complications after surgery and simplifies the surgeon's work.

Specific embodiments of the invention will now be described in detail with reference to the accompanying drawings.

〔Example〕

A surgical suturing instrument that forms linear stable stitches in accordance with the configuration of the present invention is most useful when forming staple stitches in difficult to access locations or deep within narrow surgical wounds. The surgical instrument comprises a main body 1 (FIGS. 1 and 2), which is provided with a closed rectangular frame 2. This rectangular frame 2 carries a die 4 which is fixed to the front part 3 of the frame. A staple head 5 is attached to the frame 2, and this staple head is positioned opposite to the die 4 and is attached so as to be movable back and forth with respect to the die 4.

The staple head 5 is connected to the rod 6 (Figures 1 and 3).
and a main body 8 (FIG. 4), the rod 6 being fitted into the slot 7 of the main body 1. The main body 8 houses a removable staple magazine 9, which is fixed statically within the main body 8. The staple magazine 9 has a housing 9' shaped like a right parallelepiped and a plurality of staple slots 1o (FIG. 3). A laterally movable staple ejector 11 is arranged such that its pushing blade 12 corresponds to the staple slot 10 of the magazine 9.

The housing 9' of the staple magazine 9 is provided with two lateral grooves 13 (FIG. 4), which allow the staple magazine 9 to be inserted into the staple head 5 when the staple magazine 9 is fitted into the staple head 5. It is adapted to engage with a protrusion 14 on the inner surface of the main body 8 of the stable spatula r5. In order to lock this staple magazine 9 in a predetermined position within the staple head 5, this magazine has a stapler! 15 is the provision (Fig. 5). This stone 15 is formed as a protrusion and is adapted to still contact the surface 16 of the opening 17 in the staple head 5.

The staple ejector 11 (second ('i'7+)) has a rod 18 (FIG. 6) which is located below the rod 6 of the staple head in the slot 7 ('i'7+) of the main body 1.
(Fig. 2). Staple ejector 1
1 can pass through the staple head, the staple head is provided with an opening 19 (FIG. 3).

The staple head rod 6 (FIG. 2) is provided with a hollow tailpiece 20, which has an external thread 21 and an internal thread 22.

A nut 23 is engaged with this external thread 21.

This nut 23 functions as an actuator for the staple head 5. This nut 23 has an annular groove 2
4 into the body 1, and this annular groove 2
4 cooperates with the ear portion 25 of the main body 1.

A screw 26 is engaged with the internal thread 22 of the tailpiece 20. This screw 26 acts as an actuator for the staple ejector 11. The screw 26 is provided with an annular groove 27, into which the rod 18 of the staple ejector acts via an ear 28 (FIG. 6) provided at the end of the rod 18. There is. The screw 26 is provided with a removable handle 29 (FIG. 1).

The side parts 30 and 31 of the frame 2 located laterally with respect to the die 4 are connected to the front part 3 and the rear part 32 of the frame 2.
are connected, thus giving the frame great rigidity. The frame 2 may be formed integrally as shown in FIG. 7, or one side (i.e., the side 30) thereof may be formed as a shaft portion 33 as shown in FIG. The shaft portion 33 may be detachably attached. In the case of FIG. 1, the frame 2 is configured as a U-shaped member 34 (FIGS. 3 and 8), with a front part 3 and a rear part 32 of the frame.
The free ends 35, 36 of the stylus/arms 37, 3 of the shaft 33
8 (Figure 9) straddles it. For this purpose, an opening 39 is provided in the shaft portion 33, and the frame front portion 3 is provided within this opening 39.
This shank 33 is provided with two lateral slots 40, 41, with the free end 35 of the shaft being mating. These lateral slots 40.41 are provided where the free end 36 engages the rear part 32 of the frame 2. Engaged around these lateral slots 40,41 are forks 42 formed in the free end 36 of the rear frame 32. The free end 3 of the frame is used to lock the shaft 33 in place.
5 and 36 (Figs. 3 and 8) have retainers 43
．． 44 is provided.

7 Since the U-shaped member 34 of the frame 2 constitutes a spring due to the elastic distortion of the side portion 31 that rigidly connects the front portion 3 and rear portion 32 of the frame 2, the shaft portion 33 can be freely attached and detached.

When the free end 35 of the frame front part 3 and the shaft part 33 are pressed from bottom to top toward the free end 36 of the frame rear part 32, the shaft part 33 has a stone/$38 (Figures 8 and 9).
is removed from the retainer 44, so that the shaft portion 33 can be released from the frame front portion 3 and the frame rear portion 32. When in the working position, the sides 30, 31 of the frame 2 are surrounded by the body 8 of the stable spatula P5, and these sides 30, 31 move the staple head l'' from the first position to the working position. Sometimes acts as a guide for the staple head.

During suturing, a large load is applied to the suturing mechanism due to pressure on the organ to be sutured and bending and deforming a large number of stables in one step. It is due to the high structural rigidity of the closed rectangular frame 2 (FIG. 3) of the body 1 that the staple slots 10 in the stable magazine 9 are held in a stable relationship with each other. Therefore, it is possible to minimize the cross-sectional dimensions of the front section 3 and side sections 30, 31 with the die 4 of the frame 2, and it is possible to reduce the cross-sectional dimension of the entire suturing mechanism. In this way, the operability of the suturing device within the surgical wound is improved, and it becomes possible to form delicate elastic stitches characterized by a small circular bulge in the tissue.

In the immediate vicinity of the die 4, the inner surfaces of the sides 30, 31 of the frame 2 are each provided with a longitudinal slot A5,46. The axis of each slot 45,46 is parallel to the respective side of frame 2 (FIG. 4).

The extreme recesses of the die 4, portions 47.48 provided with ``) 49.50, are located in the longitudinal slots 45.46 (FIG. 11). Similarly, the staple head 5
A work that corresponds to the suture gap that requires ff! When the staple magazine 9 is in the h position, the portion 51.52 of the staple magazine 9 provided with the extreme staple slots 53.54 (first
) are arranged in longitudinal slots 45,46 in the sides of the frame 2 (FIGS. 7 and 8).

By arranging the closed rectangular frame 2 of the main body 1 and the staple head 5 with the magazine 9 in this manner, it is possible to stitch up organs located deep within a narrow surgical wound or in difficult-to-access areas, while also allowing the suturing of organs in a free state. Staple seams at the edge of the wall of the organ 56 compressed between the magazine and the die also in cases where half of the cross-sectional circumference of the organ 56 in the area exceeds the distance between the sides 30 and 31 of the frame. 55 (FIG. 12) can be applied.

This allows the suturing device to be used more reliably in difficult to access situations.

The portion 51° 52 (10th
The width of the slot 45, 46 is approximately equal to the width of the slot 45, 46, while the width of the part of the magazine 9 corresponding to the lateral groove 13 and the part corresponding to the extreme part 51, 52 is equal. The magazine side walls in the cross section of the magazine 9 are coplanar.

(Figures 8 and 10).

The lateral grooves 13 (FIGS. 4 and 5) in the magazine 9 are defined by guide projections 57.58, which guide the frame (No. 8) when in the suturing position.
It is provided in the section regulated by the distance between the side parts 30 and 31 in Figure).

The stopper 15 (Fig. 5) of the magazine 9 is connected to this guide protrusion 5.
7 and the surface 16 of the main body 8 of the staple head 5
The staple magazine 9 can be prefixed to the staple head 5 and the slots 45, 46 (FIG. 3) in the side of the frame. With the staple magazine configured in this way, when forming staple stitches in a deep surgical wound without pulling out the frame 2 of the main body 1 from that area, for example, two straight stitches can be formed in a difficult-to-access situation. When forming and cutting organ tissue between these two seams, an empty magazine can be easily replaced with a magazine loaded with staples. That is, after forming the first stitch, the organ sutured by the first stitch is surrounded by the frame 2 of the main body 1, and while the frame remains deep within the wound, the staple head 5 is opened. The empty magazine can be replaced by removing it from the frame 2 of the main body 1 and pulling it out from the surgical wound. When the magazine 9 loaded with staples is inserted into the staple head 5, the magazine 9 is securely locked against the staple head 5 and slots 45, 46 in the side of the frame by the staple horns 4115; Insert into the surgical opening and insert the main body 1.
can be engaged with the frame 2 of.

The sides 30.31 of the frame 2, connected to the die 4, are each provided with openings 59.60 (FIG. 3), which face the longitudinal slots 45.46. These openings 59,60 allow the extreme side recesses 4 of the die 4 in the longitudinal slots 45,46 of the frame sides.
9°50 (FIG. 11) can be easily approached.

Such a feature virtually eliminates the risk of contamination of the extreme end 47.48 of the die 4 located in the longitudinal slot 45.46 of the side 30.31 of the frame 2, as well as the slot 45.46 itself. This improves the cleaning conditions for these components.

Additionally, it becomes easy to visually control the surface condition of the component in the most important area for the suturing device to function. Therefore, the suturing device can be operated for a long period of time without causing any trouble.

Edge side 30.31 of frame 2 adjacent to die 4
(Fig. 1) has protrusions 61 and 62 on its inner surface.
longitudinal slots 45, 46 (third
) are formed within the respective protrusions 61 and 62. When the staple head 5 is in its initial position (FIG. 3), the portion 51.52 of the staple magazine 9 with the extreme staple slots 53, 54 is located outside the longitudinal slots 45.46. . To move the staple head 5 from its initial position to the working position, the extreme parts 5.1, 52 of the magazine 9 are inserted into the longitudinal slots 45.
These slots 45, 46 for engagement within 46
is open on the side opposite to die 4.

The rod 6 of the staple head 5 (FIG. 1) has an ear portion 63.
is the provision. These ears 63 engage slots on the sides of the slot 7 in the body 1 to irreparably join the rod 6 to the body 1.

In the embodiment shown in FIGS. 13 and 14, each ('II section 65, 66 of the closed rectangular frame 2 is provided with a protrusion 67, 68. The forks 7 are disposed in the parts 65 and 66 adjacent to the die 69.Forks 7 are disposed at the free ends of the front part 3 and the rear part 32 of the U-shaped member of the frame 2 to which the die 69 is attached, respectively.
0 and 71 are provided (FIG. 15). The removable side portion 65 of the frame 2 is provided with side slots 72.73 into which the fork 7o fits and slots 74.75 into which the fork 71 fits.

The die 69 has extreme ends 76.77 with recesses 78.79 on the sides 65, 66 of the frame.
68 (Fig. 16).

Slots 81, 82 are provided on both end faces of the removable staple magazine 80, corresponding to the protrusions 67, 68 on the sides 65, 66 of the frame 2 (FIG. 17). The extreme staple slots 83, 84 form the portions 85 of the magazine 80 that form the slots 81, 82 and correspond to the extreme recesses 78, 79 (FIG. 16) of the die 69.
．． It is located at 86.

With this configuration, Figures 1, 2, 10,
Similar to the embodiment shown in FIG. 11, the length of the staple seam 87 (FIG. 18) formed in the organ 88 is
The distance between the sides 65 and 66 also increases. This makes it possible to form staple stitches up to the edge of organ tissue that is compressed between the magazine and the die during suturing, allowing high quality organ suturing in difficult-to-access conditions. This makes it possible to perform suturing equipment reliably.

The embodiment of the suturing device characterized in that the slot 7 (FIG. 1) of the main body 1 opens perpendicularly to the plane of the frame 2 has been described above.

However, according to a feature of the invention, the aforementioned advantages of the invention are obtained even if the slot 89 (FIG. 19) in the body 1 opens in the same direction as the plane of the frame 2. In that case, an opening 90 is provided in the free end 3G of the rear part 32 of the frame 2, and surfaces 91 and 92 of the opening 90 are provided.
(FIG. 20) shows the side surface 93.9 of the slot 89 in the main body 1.
Match 4. In order to increase the rigidity of the mutual relationship between the elongated opening 900 and the surfaces 91 and 92, a removable shaft portion 3 is provided.
3 (FIG. 21) are provided with restraining members 95,96 to prevent the thin surfaces 91, 92 from being displaced in a direction perpendicular to the plane of the frame 2. Similar to the embodiment shown in FIG. 3, longitudinal slots 45.4 are provided in the sides 30.31 of the frame 2 and accommodate the dies 4 and the extremities of the magazine 9.
6 is formed in a projection 61.62 of the side 30.31.

When the main body 1 is provided with a slot 89 (FIG. 19) that opens in the same direction as the frame 20, the suturing device can be constructed as shown in FIG. 14. That is, the side parts 65,66 of the frame 2 are provided with protrusions 67,68, respectively, and the extreme parts 76,77 (FIG. 16) of the die 69, including the recesses 78,79 on the extreme sides, are provided with these protrusions 67,68.
The extreme portions 85, 86 (FIG. 17) of the magazine 80, including the extreme staple slots 83, 84, straddle the projections 67 when the magazine 80 is in the operating position.
．． It is configured to straddle 68.

1 to 21 illustrate embodiments of the suturing device of the present invention, and the present invention can also be embodied in other embodiments. That is, for example, in the embodiment shown in FIG.
are provided with longitudinal slots 99, 100 extending over their entire length. Projections 67 and 68 on the sides of the frame 2 of the main body 1 in the embodiment described above (Fig. 14)
In this embodiment, it can be provided over the entire length of the side of the frame 2, including the extreme part of the die 69 (FIG. 16) including the extreme recesses 78 and 79, and the extreme part of the magazine 80 (FIG. 17). The extreme ends containing the staple slots straddle these protrusions 67.68.

In any embodiment of the invention, the removable staple magazine may be disposable, made of plastic, or reusable, made of metal or other suitable material. .

The operation of the surgical suturing device of the present invention is as follows.

Prior to use of the suturing device, the staple head 5 and staple ejector 11 are set to their initial positions (FIGS. 1 and 2), and the removable shaft 33 is removed from the U-shaped member of the frame 2. Next, the staple magazine 9, in which staples (not shown) have been loaded into the staple slots 10, is inserted into the staple head 5. Organ to be sutured 56 (
For example, when preparations for a normal surgical resection of the intestines (located deep within the small pelvis) are completed, the front part 3 of the frame 2 is positioned below the organ to be sutured, and the die 4 and magazine 9 are used to surround the organ.

The removable shaft 33 is then fitted over the free ends 35, 36 of the front 3 and rear 32 of the U-shaped member 34 of the frame 2 to form a frame and between the sides 30 and 31 of the frame 2. Organ 56 is restrained. Due to the relatively small size of the front part 3 carrying the die 4 and the size of the side parts 30,31 of the frame 2 and the cross-sectional size of the entire suturing mechanism, the suturing instrument can be easily inserted into the place where the stitch is to be formed. can do. Next, the nut 23 is rotated to bring the magazine 9 closer to the die 4 until a suture gap (FIG. 9) of a size corresponding to the wall thickness of the organ 56 to be sutured is obtained. Even if half of the circumference of the organ 56 in the free state exceeds the distance between the sides 30 and 31 of the frame 2, the edges of the walls of the organ 56 are compressed while the sides 30 of the frame 2
and 31 (Fig. 12). The actuator handle 29 (FIGS. 1 and 2) of the ejector 11 is then rotated to eject the staples (not shown) from the magazine 9. The staples strike the die 4 and are bent, suturing the wall of the organ 56. Once this is done,
The resected portion of the sutured organ 56 is cut along the sides of the die 4 and the magazine 9, and the magazine 9 is separated from the die 4 by turning the nut 23, and the suturing device is pulled out from the surgical wound.

When the staple head 5 is in the operating position, the extreme recess 49.50 (FIG. 11) of the die 4 and the extreme staple slot 53.54 (FIG. 10) of the magazine 9 are located on the side 30. 31, the stapled seam 55 (FIG. 12) completely closes the lumen of the sutured organ 56.

Two straight lines, such as when sewing two ends of the intestine together.
In surgical procedures that require forming staple stitches 55 and then cutting tissue between those stitches,
First, the first stitch is formed, and then the nut 23 is turned to retract the staple head 5 along the magazine 9 to its initial position. Next, the staple head 5 is extracted from the frame 2 of the main body 1 together with the magazine 9, the ejector 11, the actuator of the staple head 5, and the actuator of the ejector 11, and is removed from the surgical wound. At this time, the frame 2 of the main body 1 remains deep within the surgical wound, and the organ 56 where the first stitch was formed is surrounded by the frame 2. Next, an empty magazine and a magazine loaded with staples are exchanged outside the surgical wound. Next frame 2 and its side 3
The staple loading magazine 9 is installed in the main body 8 of the staple head 5 released from the staple head 5, and the stapler 15 is brought into contact with the surface 16 of the opening 17 of the staple head 5 (the fifth
figure). Next, the staple head 5 is inserted into the surgical wound and into the internal space of the frame 2 of the main body 1. Next, move the frame to the first staple seam,
Position the die 4 below the organ 56 to be sutured, 3 to 5 distances from the initial suture line. The magazine 9 is then brought close to the die 4 to ensure a stitching gap and a second staple stitch is formed parallel to the first staple stitch as in the first case.

Then, while moving the scalpel along the sides of the magazine 9 and the die 4, the wall of the organ 56 is cut.Turn the knife 23t to separate the magazine 9 from the die 4, and pull out the suturing device from the surgical wound.

By fixing the magazine 9 within the staple head 5 using the stopper 15, the staple head 5 can be securely placed together with the magazine 9 within the internal space of the closure frame 2 even when operating deep within a surgical wound or under difficult access conditions. and can be inserted safely. Due to this structural feature of this suturing device, it is possible to form two stitches parallel to each other even in difficult access situations, so that the suturing device 56 can be placed under the sutured organ 56 by the first stitch. The empty magazine 9 can be replaced with a magazine loaded with staples without removing the part 3 with the dice 4 from the frame, and the part 3 with the dice 4 can be replaced with a magazine loaded with staples.
A second stitch can be formed without repeatedly inserting the sutured organ 56 under the sutured organ 56. The risk of trauma to the organ to be sutured as well as the surrounding tissue is therefore reduced, and the range of technical applications of the suturing device is expanded.

This is important for actual surgery.

When using a suturing device equipped with an inseparable closed rectangular frame 2 as shown in FIG.
The organ to be sutured (for example, the atrial appendage of the heart) is introduced into the space formed between the frame 2 and the frame sides 30, 31 in a direction perpendicular to the plane of the frame 2. When the missing part of the organ to be sutured is a solid agglomerate and cannot be inserted between the die 4 and the magazine 9, as in the case of suturing the pharynx in surgery for laryngeal cancer, Before using the device, the main body 1 must be disassembled from the rest of the device. Then, the internal opening of the closing frame 2 of the main body 1 is the magazine 9.
and is released from the staple head 5 together with the staple ejector 11. While passing the tumor mass to be resected through the wide internal opening of the frame 2, the front part 3 of the frame was brought to the suture site located between the jaw and the ribcage rising from the tumor, and the suturing instrument was moved. The staple head 5 combined with the remaining components is engaged with the main body 1.

The other steps in the use of a suturing device in which the closure frame 2 of the main body 1 is not separable are exactly the same as in the case of a suturing device in which the sides of the frame are removable. The narrowness of the sides 30.31 of the frame 2 and its front part 3 and the magazine 9 makes it possible to easily set the suturing device into the suturing position without causing trauma to the organ 56 to be sutured or the surrounding tissue. In addition, circular ridges of tissue can form small delicate seams, and the structural features of this suturing mechanism can result in the formation of inappropriate seams or the absence of seams at the edges of sutured organs. This prevents bleeding and ensures good hemostasis.

Using the method described above, closed rectangular frame 2 (third
It is also possible to use a suturing device having a removable side 30 in the form of a removable shaft 33 but not having a removable side 30 in the form of a removable shank 33. With this configuration of the suturing device, the magazine in the staple head 5 can be replaced while the frame is closed and the frame remains engaged with the staple head 5 and other components. To do this, the staple head 5 is retreated to the initial position, the staple head is slightly lifted above the frame while pushing the navel P5 in a direction perpendicular to the plane of the frame, and the staple head escapes from the internal opening of the frame. When inserting and removing the magazine 9 into and out of the staple head 5, it is necessary to prevent the side portions 30 of the frame from interfering with the magazine. Rod 18 of ejector 11 (FIG. 2) and staple head 5
The rod 6 remains fitted within the slot 7 of the body 1. Once the magazine 9 loaded with the staple has been installed in the main body 8 of the staple head 5, the staple head together with the magazine 9 is pushed down into the internal opening of the frame 2. The suturing device is then ready for use.

The operation of the embodiment shown in FIGS. 13 to 17 is as follows.
There is basically no difference from the embodiments shown in FIGS. 2, 2, 1O, and 11. The only difference is the relative relationship between the magazine extreme with the extreme stable slot and the die extreme with the extreme recess, and therefore the relative relationship of the extreme stable of the seam to the side of the frame. (Figures 12 and 18
figure).

The embodiment shown in FIGS. 19 to 22, that is, the main body 1
The operation of this embodiment does not differ substantially from that of the first embodiment, characterized in that the slot 89 (FIG. 19) opens in the same direction as the plane of the frame.

However, it should be noted that in this embodiment, the magazine cannot be replaced until the shaft 33 is removed from the U-shaped member 34 of the frame 2.

〔Effect of the invention〕

As described above, the structural features of the suturing device of the present invention described in the claims increase the rigidity of the suturing mechanism of this suturing device, and increase the cross-sectional dimensions of the supporting portion and side portions of the frame as well as the entire suturing mechanism. As the cross-sectional dimensions of
This makes it possible to form a stable seam with a length exceeding half the circumference of the organ when compressed during suturing. As such, the seams formed by the device of the invention are highly reliable whenever half the circumference of the organ to be sutured is less than the distance between the sides of the frame. It exhibits stability as well as good airtightness and hemostatic properties, and half of the length of the organ to be sutured in the free state is equal to the distance between the sides of the frame or If this value is exceeded, high quality seams can be formed.

Experimental suturing of selected parts of various organs such as lungs, intestines, auricles of the heart, etc. in such conditions that half of the organ's length exceeds the distance between the sides of the frame. As a result of the experiment, we were able to completely suture the edges of the organs to be sutured in all cases. The suturing device of the present invention can be effectively used in the following cases. That is, when performing suturing within a narrow and deep surgical wound - a surgical procedure in which an organ is sutured using the suturing device or stable stitch of the present invention in a difficult-to-access location, and then another suture is created by hand sewing. When there is little space to manipulate the equipment - such as when suturing delicate tissue where needles and threads can easily penetrate, or when suturing organs that have previously been treated with a beam, hand sewing may be necessary. If it is extremely undesirable to apply another stitch by forming a stable stitch and cutting the resected part of the organ, the sutured organ stump may slip through immediately after separating the magazine and die. This may be the case when the stump is difficult to distinguish from the surrounding tissue for revision, or when the lack of stable stitches can lead to profuse bleeding.

Suturing devices according to features of the present invention improve the quality of the stitches formed, extend the functional capabilities of the suturing device, and allow suturing devices to be used more reliably in a variety of surgical procedures in infants and adults. It makes it possible to use it.

[Brief explanation of the drawing]

FIG. 1 is an overall view of the surgical suturing device of the present invention, FIG. 2 is a sectional view taken along the line n-■ in FIG. 1, and FIG.
A sectional view taken along line I-III, FIG. 4 is a cross-sectional view taken along line IV- in FIG.
5 is a sectional view taken along the line v-M in FIG. 3, FIG. 6 is a sectional view taken along the line Vl-M in FIG. 2, and FIG. Figure 8 is a partial cutaway view of the suturing device with a real body frame; Figure 8 is a partial cutaway view showing the staple head in the operating position; Figure 9 is a line IX-IX of Figure 3; 10th cross-sectional view along
The figure is a cross-sectional view taken along the line X-X of Figure 8, and Figure 11 is a cross-sectional view of the
12 shows the formation of a straight staple seam in an organ placed between the sides of the frame; FIG. Another embodiment of the suturing device of the invention is shown, and FIG. 14 is a sectional view of the frame and staple head viewed along the axis of the device, and FIG. 14 is a sectional view taken along line W-W in FIG. 13. , Fig. 15 is a cross-sectional view taken along the line xv-xv in Fig. 14, Fig. 16 is a cross-sectional view taken along the hole-W line in Fig. 14, and Fig. 17 is a cross-sectional view taken along the line W in Fig. 14. 18 shows a straight staple seam formed in an organ interposed between the sides of the frame; and FIG. 20 shows a sectional view along the staple head. FIG. 21 is a sectional view taken along the line XXI-XXI in FIG. 19, and FIG. 22 shows still another embodiment of the present invention. FIG. 3 is a cross-sectional view of the frame and staple head taken along an axial plane. 1...Device body, 2...Closed rectangular frame, 3...
・Front part of frame, 4...Dice, 4'...Dice recess, 5...Staple head, 6...Staple throat rod, 7...Slot, 8...Staple head body, 9... detachable staple magazine, 9'... magazine housing, 10... staple slot, 11... staple ejector, 12
...Ejector push blade, 13...Side groove, 14...
Projection, 15... Stopper, 16... Surface, 17...
Opening, 18... Ejector rod, 19... Opening,
20...Hollow tailpiece, 21...Outer thread of tailpiece, 22...Inner thread of tailpiece, 23...
- Nut, 24... Annular groove of main body 1, 25... Ear part of main body 1, 26... Screw, 27... Annular groove of screw 26, 28... Ear part of rod 18, 29 ···handle,
30.31... Side part of the frame, 32... Rear part of the frame, 33... Shaft part, 34... U-shaped member of the frame, 35.36... Freedom of the frame! , 37.3s・
... Stopper, 39... Shaft opening, 40.41...
・Side slot of shaft part, 42...Fork, 43.4
4...Retainer, 45.46...Slot on side of frame, 47.48...Dice part, 49.50
...Recess on the extreme side of the die, 51.52... Part of the staple magazine, 53.54... Staple slot on the extreme side of the staple magazine, 55... Staple f
=fA/stitch, 56...organ to be sutured, 57.
58... Guide protrusion, 59.60... Opening on the side of the frame, 61° 62... Protrusion on the side of the frame, 63...
・Ear part, 64...Slot, 65.66...Side part,
67.68... Protrusion of side part 65.66, 69... Die, 69'... Recess of die 69, 70.71.
...Fork, 72.73°74.75...Slot, 76.77...Extreme part of die 69, 78.79.
...Recess on the extreme side of die 69, 80... Staple magazine, 81.82... Slot of staple magazine, 83.84... Staple slot on the extreme side of staple magazine, 85.86... Staple magazine. 87... Staple seam, 88... Organ to be sutured, 89... Slot, 90... Opening,
91.92...Face of opening 9°, 93.94...Side surface of slot 89, 95°96...Restriction member, 97.9
8... Frame side part, 99,100... Frame side part 97.98 slot.

Claims (1)

[Claims] 1. A main body with a closed rectangular frame (2) (
1), a die (4) fixed to one side (3) adjacent to two sides (30, 31) of the closed rectangular frame (2) and provided with a plurality of recesses (4'); (
a staple head (5) disposed inside the frame (2) on the opposite side of the frame (2) and mounted movably relative to the frame; and a staple head (5) having a plurality of staple slots (10) and stationary relative to the staple head. a removable staple magazine (9) adapted to be mounted in the staple head (5), and a staple slot (10) in the staple magazine (9) movably mounted in said staple head (5); ), and actuators (23, 2) mounted in the main body (1) for actuating the staple head (5) and the staple ejector (11).
6), and is a surgical suturing device for forming a linear staple seam, and its feature is that the side edge (2) of the frame (2) is
30, 31) are respectively provided with slots (45, 46) on their inner surfaces near the die (4), and the axes of the slots (45, 46) are on the respective sides of the frame (2). a portion parallel to the sides (30, 31) and provided with an extreme recess (49, 50) of said die (4) and an extreme staple slot (53, 54) of said staple magazine (9); When the staple magazine (9) is in the suturing position, the part with the frame (2)
a surgical suturing device, comprising being placed inside said slots (45, 46) of the sides (30, 31) of the surgical suturing device. 2. When the detachable staple magazine (9) is in the suturing position, the sides (30, 3) of the frame (2)
2. The surgical suturing device according to claim 1, wherein the width of the portion located inside the slot (45, 46) of 1) is equal to the width of the slot (45, 46). 3. The staple magazine (9) includes guide protrusions (57, 58) for fitting the staple magazine into the staple head (5), and the guide protrusions (57, 58)
) is located in a portion of the staple magazine defined by the distance between the sides (30, 31) of the frame (2) when in the suturing position. suturing equipment. 4. The width of the portion of the staple magazine (9) corresponding to the side groove (13) formed by the guide protrusions (57, 58) is equal to , 31) of the slot (45
, 46), the surgical suturing device according to claim 3, wherein the width is equal to the width of the portion fitted inside of the surgical suturing device. 5. The sides (30, 31) of the frame (2) are provided with openings (59, 60) in the portions adjacent to the dice (4), respectively.
are provided, and the openings (59, 60) each have a slot (45).
, 46), the surgical suturing device according to any one of claims 1 to 4. 6. Protrusions (61, 62) are provided on a part of the inner surface of each side (30, 31), and the protrusions (61, 62)
is adjacent to the die (4) and the slot (45,
46) are respectively formed in the protrusions (61, 62), and the slots (45, 46) are open on the side opposite to the die (4).
The surgical suturing device according to any one of Items 1 to 5. 7. Main body with closed rectangular frame (2)
1) in which protrusions (67, 68) are provided on the inner surfaces of the sides (65, 66) of the frame, respectively, and the side (6S) and the side of the closed rectangular frame (2). (6
6) is fixed to one side (3) between the
, 79);
) a staple head (5) disposed in the frame (2) and movably mounted with respect to the frame; and a staple head (5) comprising a plurality of staple slots (10); a removable staple magazine (80) adapted to be statically mounted within said staple head (5); and a staple slot (80) in said magazine (80) movably mounted within said staple head (5). a staple ejector (11) disposed corresponding to the main body (10); a staple head (5) and a staple ejector (11) disposed within the main body (1);
actuators (23, 26) for activating the staple magazine (23, 26), and is a surgical suturing device for forming linear staple stitches; Each end face of the frame (2) has a side (6) of the frame (2).
Slots (81, 82) are provided corresponding to the protrusions (67, 68) of the staple magazine (80), respectively, and the staple slots (83, 82) on the extreme side of the staple magazine (80)
84) are arranged in the portion where the slots (81, 82) are formed, and the recesses (78, 79) on the extreme side of the die (69) are arranged in the portion where the slots (81, 82) are formed, and the recesses (78, 79) on the extreme side of the die (69)
, 84), and the extreme parts of the die (69) with the extreme recesses (78, 79) correspond to the protrusions (67, 68) on the sides (65, 66) of the frame (2). )
A surgical suturing device consisting of straddling. 8. The respective protrusions (67, 68) are connected to the respective sides (65
, 66) adjacent to the die (69). 9. The removable staple magazine (9) is provided with a stopper (15) in the form of a protrusion, the stopper (15) is designed to prevent the stapler from stopping the stapler on the side of the staple head (5) and/or the frame (2). 30, 31) or the projections (61, 62). The surgical suturing device according to item 6.